An international tool to measure perceived stressors in intensive care units: the PS-ICU scale

Abstract

Background The intensive care unit is increasingly recognized as a stressful environment for healthcare professionals. This context has an impact on the health of these professionals but also on the quality of their personal and professional life. However, there is currently no validated scale to measure specific stressors perceived by healthcare professionals in intensive care. The aim of this study was to construct and validate in three languages a perceived stressors scale more specific to intensive care units (ICU). Results We conducted a three-phase study between 2016 and 2019: (1) identification of stressors based on the verbatim of 165 nurses and physicians from 4 countries (Canada, France, Italy, and Spain). We identified 99 stressors, including those common to most healthcare professions (called generic), as well as stressors more specific to ICU professionals (called specific); (2) item elaboration and selection by a panel of interdisciplinary experts to build a provisional 99-item version of the scale. This version was pre-tested with 70 professionals in the 4 countries and enabled us to select 50 relevant items; (3) test of the validity of the scale in 497 ICU healthcare professionals. Factor analyses identified six dimensions: lack of fit with families and organizational functioning; patient- and family-related emotional load; complex/at risk situations and skill-related issues; workload and human resource management issues; difficulties related to team working; and suboptimal care situations. Correlations of the PS-ICU scale with a generic stressors measure (i.e., the Job Content Questionnaire) tested its convergent validity, while its correlations with the Maslach Burnout Inventory-HSS examined its concurrent validity. We also assessed the test–retest reliability of PS-ICU with intraclass correlation coefficients. Conclusions The perceived stressors in intensive care units (PS-ICU) scale have good psychometric properties in all countries. It includes six broad dimensions covering generic or specific stressors to ICU, and thus, enables the identification of work situations that are likely to generate high levels of stress at the individual and unit levels. For future studies, this tool will enable the implementation of targeted corrective actions on which intervention research can be based. It also enables national and international comparisons of stressors’ impact.

Perceived Quality of Life in Intensive Care Medicine Physicians: A French National Survey

“…However, as previously demonstrated that it is not the objective characteristics of a stressful situation (nature, severity, frequency) that influence the subject's ability to adapt to the situation, but rather the subjective evaluation that the subject cares, in other words how he perceives the situation. 18 Second, our questionnaire did not explore unit management, thus we cannot exclude the possibility that the respondents are selected and that our results are not extendable to all the units. Third, our study is limited at a single country (France) and only one medical discipline (intensivist), however, we deliberately started with a French survey because of the very different organizations of ICU exists in Europe.…”

“…What influences an individual's ability to cope are primarily the subjective evaluation that the subject makes of it, that is, how he or she perceives the situation. 18 Thus, the effect of perceived stress on the health of professionals is more significant than objective measures of events. Perceived stress has also been shown in many studies to be more predictive of the individual's subsequent health status than actual stress.…”

Psychometric properties of the Chinese version of the Intensive Care Experience Questionnaire(ICEQ)

“…A variety of experience assessment tools have been developed [21][22][23], among which the ICEQ has been widely used in UK, US, Australia and other countries, but China still focuses on qualitative research in related elds [24][25], and lacks scienti c assessment tools to quantify ICU patient experience. ICEQ was compiled by Rattray et al [21] based on The Intensive Care Unit Environmental Stressor Scale (ICUESS) and The Intensive Care Unit Memory Tool (ICUMT) and combined with extensive previous literature research and qualitative research [26][27].…”

Risk and protective factors for the possible development of post-traumatic stress disorder among intensive care professionals in France during the first peak of the COVID-19 epidemic

“…Health crises such as the current COVID-19 pandemic, are particularly traumatic for HCWs and can severely and durably affect their mental health (Laurent, Fournier, Lheureux, Louis, et al, 2021; Laurent, Fournier, Lheureux, Martin Delgado, et al, 2021 ). Particular attention should therefore be paid to the potential traumatic effects of the pandemic on ICU HCWs, to better understand how they cope with the situation, and what coping mechanisms they used.…”